Perimenopause and menopause can be incredibly challenging for women. It’s when most women experience a variety of symptoms linked to the decline of estrogen, such as hot flashes, weight gain, brain fog and sleep issues. However, this period of time may also increase their risk of developing autoimmune diseases, or affecting a current diagnoses. Today I’m going to highlight a few autoimmune diseases and the impact of this female transition on them.
What is Perimenopause and Menopause?
Perimenopause and menopause are one of the 3 times women experience major hormonal shifts. Menopause marks the period of time when a woman completely loses her menstrual cycle and is no longer able to get pregnant. In other words, her egg supply is depleted. In order for a woman to be in menopause, she has to go a year without a period. Preceding this transition is perimenopause. Perimenopause is when a woman starts experiencing this hormonal shift that ends in menopause. It typically happens anywhere from 3-10 years before menopause, and begins when estrogen starts to decline. Symptoms of perimenopause include:
- Irregular periods
- Mood changes, including depression
- Low libido or sex drive
- Hot flashes
- Night sweats
- Vaginal dryness
- Sleeping issues
- Brain fog
What Happens to the Immune System During Perimenopause and Menopause?
Estrogen is an anti-inflammatory hormone. When estrogen declines, inflammation can increase throughout the body. In fact, postmenopausal women typically see an increase in several inflammatory markers, as well as a decline in lymphocyte activity. In other words, they have more inflammation and less immune cells to fight inflammation. The pro-inflammatory state started by perimenopause and continues through menopause raises the risk of developing other inflammatory related diseases like type 2 diabetes, cardiovascular disease, alzheimer’s disease and autoimmune diseases.
Overview of Impact on Specific Autoimmune Diseases
Here are a few autoimmune diseases that have been studied for their impact on perimenopause and menopause
Multiple Sclerosis (MS)
Multiple sclerosis (MS) affects women twice as much as men. It is also misdiagnosed in older patients as the symptoms track with regular aging. As estrogen levels decline, pro-inflammatory markers like interleukin 1 (IL-1), Interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) increase, which is also similar to what MS patients experience at the onset of their disease. Additionally, the drop in estrogen affects the brain and may lead to neurodegeneration.
Systemic Lupus Erythematosus (SLE)
Research has shown that the incidence of SLE peaks around the time of perimenopause, and then declines after menopause. Also, flares postmenopause tend to decline. This is also consistent with the effect of estrogen on the helper T-cells that I’ve discussed in the past. The drop in estrogen may be protective for women with SLE. However, researchers have found that post menopausal flares tend to do more damage to organs than flares prior to this time.
Rheumatoid Arthritis (RA)
Women are four times as likely to develop RA than men, and the risk of developing RA is higher around reproductive and perimenopausal age groups. Menopause typically worsens symptoms for women with RA, including more severe joint destruction. However, researchers have found that hormonal therapy after menopause can have a protective effect on the progression of RA.
What can you do to protect yourself?
While developing autoimmune diseases may feel like it is out of your control, it’s not. And neither is the progression of your disease if you already have one. Instead of worrying about your genetics, focus on what you can control. Because many of these chronic illnesses are not triggered by genetics only. Here are a few things you can focus on to help you during this transitional time:
Diet
Since a decline in estrogen increases inflammation, focus on foods that lower inflammation. This includes eating whole foods like vegetables, animal and plant proteins, fruits, and whole grains. Fill your plate with colors. Colorful foods have lots of phytochemicals that fight inflammation. Try to eat less inflammatory foods like processed sugar, processed foods, fried foods, additives and chemicals
Stress
Stress is a big one, especially during this transitional time. Many women are stressed about their own health while managing their kids and their aging parents. It’s a lot! Figure out ways to lower your stress. This might look like a meditation practice, or spending time in nature, or setting aside 20 minutes a day for some breathwork. Lowering stress will do wonders for your body and mind.
Sleep
Perimenopause and menopause definitely mess with your sleep. Make sleep quality a priority for you. This may include getting on a regular sleep schedule, abstaining from alcohol (sorry!), or getting some sleep aids to make your bedroom cooler and more optimal for sleep.
Perimenopause and menopause can be significantly challenging to navigate. With all of the risks that come with this transition, it’s important to be an advocate for your health, find health practitioners who align with your beliefs and goals. If you need help managing inflammation during this transitional time, please contact me for help. In addition, you can follow me on my social media channels (Instagram, Facebook and YouTube) for more tips on how to manage your autoimmune disease with diet and lifestyle.
